ELLIOT PROFESSIONAL SERVICES (NPI# 1013976810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013976810 |
| Entity Type | Organization |
| Organization Name | ELLIOT PROFESSIONAL SERVICES |
| Other Organization Name | NEONATOLOGY SERVICES |
| Practice Address |
1 Elliot Way Neonatology Services Manchester NH 03103-3502 |
| Practice Telephone | 6036632692 |
| Practice Fax Number | 6036633982 |
| Mailing Telephone | 6036632692 |
| Mailing Fax Number | 6036633982 |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2008-06-20 |
| Authorized Official Name | RICHARD P. HERMAN (DIRECTOR OF OPERATIONS & FINANCE) |
| Authorized Official Telephone | 6036634904 |
| Is Organization Subpart | Y |
| Parent Organization Name | ELLIOT PROFESSIONAL SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | 30212431 | 05 | |
| NH | RR MEDICARE | CK3360 | 01 |
| Other Name | Type Code |
|---|---|
| Neonatology Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780975953 | Elliot Professional Services | Obstetrics & Gynecology | 15 Nelson St Fl 2, Elliot Obstetrics and Gynecology, Manchester, NH 03103-2706 | 2011-04-22 |
| 1598054389 | Elliot Professional Services | Pediatrics | 275 Mammoth Rd, Suite 1, Elliot Pediatric Gastroenterology, Manchester, NH 03109-4126 | 2011-04-01 |
| 1548442213 | Elliot Professional Services | Internal Medicine | 33 S Commercial St Ste 401, Elliot Palliative Care Services, Manchester, NH 03101-2626 | 2007-12-04 |
| 1669431466 | Elliot Professional Services | Psychiatry & Neurology | 445 Cypress St Ste 8, Elliot Behavioral Health Services, Manchester, NH 03103-3600 | 2006-03-21 |
| 1386610020 | Elliot Professional Services | Internal Medicine | One Elliot Way, Hospitalist Program, Manchester, NH 03103 | 2006-02-23 |
| 1568438349 | Elliot Professional Services | Radiology | Meeting Place Plaza 199 - Route 101, Greater Amherst Imaging, Amherst, NH 03031 | 2006-02-23 |
| 1285627935 | Elliot Professional Services | Emergency Medicine | 1070 Holt Ave, Unit 1, Suite 2200, Manchester, NH 03109-5603 | 2005-08-29 |
| 1912255118 | Elliot Professional Services | Dermatology | 185 Queen City Ave, Elliot Dermatology, Manchester, NH 03101-7121 | 2012-08-17 |
| 1104187442 | Elliot Professional Services | Urology | 275 Mammoth Rd Ste 1, Elliot Pediatric Urology, Manchester, NH 03109-4133 | 2012-06-04 |
| 1093072407 | Elliot Professional Services | Obstetrics & Gynecology | 1 Elliot Way, Elliot Maternal Fetal Medicine, Manchester, NH 03103-3502 | 2012-04-23 |
| Street Address |
1 ELLIOT WAY NEONATOLOGY SERVICES |
| City | MANCHESTER |
| State | NH |
| Zip Code | 03103-3502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922006253 | Benjamin J Grudinskas Jr. | Anesthesiology | 1 Elliot Way, Manchester, NH 03103-3502 | 2005-07-11 |
| 1437766904 | Samantha Oslin | Nurse Practitioner | 1 Elliot Way, Manchester, NH 03103-3599 | 2020-09-28 |
| 1104439603 | Kerry Mcdonald | Nurse Practitioner | 1 Elliot Way, Manchester, NH 03103-3502 | 2020-08-25 |
| 1851912331 | Katrina M Sibley | Nurse Anesthetist, Certified Registered | 1 Elliot Way, Manchester, NH 03103-3502 | 2020-05-06 |
| 1346861895 | Rebecca Lauren Hicks | Registered Nurse | 1 Elliot Way, Manchester, NH 03103-3502 | 2020-05-06 |
| 1386270320 | Brooke E Kanehl | Registered Nurse | 1 Elliot Way, Manchester, NH 03103-3599 | 2020-03-22 |
| 1598306383 | Rachel Marie Baroody | Registered Nurse | 1 Elliot Way, Manchester, NH 03103-3502 | 2019-10-02 |
| 1407417355 | Oluwatoyin Oshin | Registered Nurse | 1 Elliot Way, Manchester, NH 03103-3502 | 2019-06-21 |
| 1316504103 | Diana Renee Tanner | Nurse Practitioner | 1 Elliot Way, Manchester, NH 03103-3502 | 2019-05-28 |
| 1376004622 | Courtney A O'connor | Registered Nurse | 1 Elliot Way, Manchester, NH 03103-3599 | 2019-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023583374 | Melissa K Bascom | Social Worker | C/o Care Coordination Department, 1 Elliot Way, Manchester, NH 03103 | 2018-10-12 |
| 1538650650 | Bluestone Healthcare Services L.L.C. | Physician Assistant | Bluestone Healthcare Services LLC 169 South River Rd, Bedford, NH 03103 | 2018-05-24 |
| 1538662424 | Minal Jamkhande | Pharmacist | 50 S Willow Street, Manchester, NH 03103 | 2018-03-16 |
| 1447776240 | Manchester Health Supplies | Durable Medical Equipment & Medical Supplies | 373 S Willow Street, #328, Manchester, NH 03103 | 2017-08-14 |
| 1184145898 | Susan E Herman | Physical Therapist | 3000 Goffs Falls Road Suite 101, Manchester, NH 03103 | 2017-07-03 |
| 1316476757 | Sara Rose Hanrahan | Occupational Therapist | 3000 Goffs Falls Road, Suite 101, Manchester, NH 03103 | 2017-06-08 |
| 1457802811 | Holly Ann Cekala | Counselor | 140 Central St, Manchester, NH 03103 | 2016-10-20 |
| 1114301249 | Families In Transition | Counselor | 282 Belmont St, Manchester, NH 03103 | 2015-07-18 |
| 1083092282 | Alexander Michael Jones | Family Medicine | 4 Elliot Way Ste 105, Manchester, NH 03103 | 2015-05-08 |
| 1518344100 | Janiris Ruth Matos | Dentist | 8 Vinton Street, Dental Clinic, Manchester, NH 03103 | 2015-05-03 |
| Find all providers in zip 03103 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194785402 | Ernest F. Beale | Pediatrics | Neonatology Services - Elliot Hospital, One Elliot Way, Manchester, NH 03103 | 2006-03-23 |
| 1679919658 | Jessica G Clem | Pediatrics | 100 Mcgregor St, Manchester, NH 03102-3730 | 2013-05-16 |
| 1528389780 | Elliot Professional Services | Pediatrics | 275 Mammoth Rd, Suite 1c, Manchester, NH 03109-4133 | 2010-06-22 |
| 1548495468 | Matthew William Ryzewski | Pediatrics | 1 Elliot Way, Nicu, Manchester, NH 03103-3502 | 2009-05-20 |
| 1720271224 | Amy D Mcbee | Pediatrics | 71 Haynes St, Neonatal Icu, Manchester, CT 06040-4131 | 2007-08-20 |
| 1770690372 | Malgorzata Bulanowski | Pediatrics | 1 Elliot Way, Neonatology Department, Manchester, NH 03103-3502 | 2006-08-23 |
| 1851353049 | Deborah A. Franzek | Pediatrics | 1 Elliot Way, Neonatology Services - Elliot Hospital, Manchester, NH 03103-3502 | 2006-04-04 |
| 1255314761 | Jorge Alba | Pediatrics | 71 Haynes St, Manchester, CT 06040-4131 | 2005-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891962916 | Neetu Singh | Pediatrics | 1 Medical Center Dr, Dhmc Department of Neonatology, Lebanon, NH 03756-1000 | 2008-05-08 |
| 1972611911 | Gautham K Suresh | Pediatrics | 1 Medical Center Dr, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756-1000 | 2006-08-29 |
| 1871600569 | George Alexiy Little | Pediatrics | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-08-25 |
| 1497863948 | Robert A. Darnall Jr. | Pediatrics | 1 Medical Center Dr, Dhmc. Department of Pediatrics, Lebanon, NH 03756-1000 | 2006-08-25 |
| 1407963648 | William Horton Edwards | Pediatrics | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-08-24 |
| 1164489423 | Steven Alan Ringer | Pediatrics | 1 Medical Center Dr, Dhmc/neonatology, Lebanon, NH 03756-1000 | 2006-04-28 |
| 1891750717 | Juliette Carr Madan | Pediatrics | 1 Medical Center Dr, Dhmc Division of Neonatology, Lebanon, NH 03756-1000 | 2006-04-20 |
| 1750379582 | James E Gray | Pediatrics | 1 Medical Center Dr, Dartmouth Hitchcock - Neonatology, Lebanon, NH 03756-1000 | 2005-10-06 |
| City | MANCHESTER |
| Zip Code | 03103 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.